全膝关节置换术治疗外翻膝的手术技术进展

The progress of surgical technique of total knee arthroplasty for valgus knee

骨性关节炎、类风湿关节炎、创伤性关节炎等疾病终末期常合并膝关节畸形,人工膝关节置换术(TKA)已成为治疗各种终末期膝关节疾病的一种有效方法,其旨在缓解疼痛,纠正力线,改善生活。外翻畸形是较少见的一种膝关节畸形,常合并骨性结构和软组织改变,涉及术前准备、手术入路、术中截骨、软组织平衡、假体选择等多方面,其中软组织平衡则是重中之重,直接关系到术后关节功能,假体稳定性、使用寿命等问题,手术较内翻膝困难,国内外对于相关问题仍存在争论。因此如何纠正力线,如何平衡软组织,对于外科医师也是一个严峻的挑战。

The end-stage of osteoarthritis, rheumatoid arthritis, traumatic arthritis is often associated with joint deformity, total knee arthroplasty(TKA) has become effective treatment to treat end-stage osteoarthritis of the knee, aimed at correcting the lines of force and reducing the pain. Valgus deformity is a rare deformity of the knee and it is often associated with bony structures and soft tissue changes, which is involving preoperative preparation, surgical approach, surgical osteotomy, soft tissue balance and prosthesis selection etc, soft tissue balance is the most important, and is directly related to the postoperative joint function and stability of the prosthesis lifetime, operation is more difficult than varus knee, and related issues are still in dispute at home and abroad. So how to correct the force line and achieve the balance of soft tissue is the key to TKA, and also a serious challenge to the surgeon.